Provider Demographics
NPI:1720632003
Name:BRESEE, KATELYN BRIANNE (NP)
Entity type:Individual
Prefix:MRS
First Name:KATELYN
Middle Name:BRIANNE
Last Name:BRESEE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:528 CEDAR AVE
Mailing Address - Street 2:
Mailing Address - City:WINNIE
Mailing Address - State:TX
Mailing Address - Zip Code:77665-8868
Mailing Address - Country:US
Mailing Address - Phone:409-659-1484
Mailing Address - Fax:
Practice Address - Street 1:102 AIRPORT ROAD
Practice Address - Street 2:
Practice Address - City:ANAHUAC
Practice Address - State:TX
Practice Address - Zip Code:77514
Practice Address - Country:US
Practice Address - Phone:409-267-2730
Practice Address - Fax:409-267-3099
Is Sole Proprietor?:No
Enumeration Date:2019-07-25
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP141967363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily